• What are GLP-1s, and what are they used for? GLP-1s, or glucagon-like peptide-1 receptor agonists, are a class of drugs that are gaining popularity for treating chronic conditions. While they are known for helping with weight loss, they are primarily used to manage chronic illnesses like Type 2 diabetes.
   
• Will GLP-1s still be covered when prescribed for diabetes? Yes. The district is not removing coverage for diabetes treatment. Members are still responsible for any applicable copays or coinsurance. These amounts will remain unchanged for 2026.
   
• Why is the district removing GLP-1 coverage for use other than diabetes? The decision is based on cost. GLP-1 medications for weight loss and other non-diabetic conditions are among the fastest-growing and most expensive categories of prescriptions nationwide. Covering these medications at their current utilization levels places significant strain on the district’s self-funded health plan. Removing this coverage is projected to save $1.23 million, which is critical for making the fund financially sustainable. The fund's medical expenses have been rising at an average annual rate of 17-18%, far outpacing the national average. By removing this coverage, Parkway can continue offering a comprehensive benefits package while keeping the fund viable for all members into the future.
   
• Why can't the district share the cost with employees? Our prescription coverage is administered through Express Scripts, which uses a national formulary (list of covered medications). This formulary does not allow a “partial coverage” or cost-sharing option for certain drugs. If Parkway were to customize the formulary to allow employees to pay part of the cost for GLP-1s, we would lose access to $3 million in rebates and savings that were negotiated in our current contract. That change would ultimately increase overall costs, making it more challenging to maintain affordable and sustainable coverage.
   
• Is the elimination of GLP-1 coverage a permanent change? The hope is that this is not a permanent change. The district needs to bring its self-insurance fund to a sustainable level in order to continue paying health insurance claims for its employees. If the cost of these pharmaceuticals decreases in the future, the district may be able to revisit covering them.
   
• Did the Benefits Advisory Committee explore ways to keep coverage for GLP-1s? Yes, the Benefits Advisory tried to come up with creative solutions that would have allowed us to continue coverage for GLP-1s for weight loss and other non-diabetes reasons. However, we found that those ideas would have modified the formulary and caused us to lose significant rebates we receive for GLP-1s. This would have made these medications even more expensive. This is because our current contract with Express Scripts doesn't give us much flexibility. Unfortunately, we're in an all-or-nothing situation with this coverage. This doesn't mean it's a permanent decision. The cost of these medications may decrease in the future, or we can require more flexible formulary terms when we negotiate our next contract with a pharmacy benefits manager, which is currently Express Scripts.
   
• What happens to employees currently on GLP-1s for weight loss? Coverage for GLP-1s prescribed for weight loss will continue through the end of the current plan year (December 31). While Express Scripts does not offer a step-down or titration program for these medications, we encourage employees to work closely with their prescribing physician to discuss next steps and plan for ongoing care.
   
• What support and resources are available for employees? The district offers several alternative resources to help employees manage their health:
  • Real Appeal: A coaching program with specialized coaches and online tools to help with weight management.
  • Teladoc: A digital health company that helps patients manage chronic diseases.
     
• Are there any other options for employees who want to continue taking GLP-1s? The district recommends discussing alternative options with their doctor. If employees obtain these medications outside of our health plan, any out-of-pocket expense would not apply to your deductible or out-of-pocket maximum.

Our Commitment

Taking care of our staff and their families means providing quality and accessible health care. Parkway is committed to maintaining high-quality health benefits while addressing the financial challenges that threaten our ability to cover medical claims and provide the level of care our staff rely on.

These health insurance adjustments are part of our comprehensive approach to ensuring Parkway's long-term sustainability. Just as we've taken proactive steps with our overall budget—including forming a Budget Task Force to explore ways to reduce operating expenses—we're addressing rising healthcare costs now to protect both our health coverage and our district's financial stability.

Why Changes Are Needed

Like many districts across Missouri and the nation, Parkway is facing steep increases in healthcare costs—up 14% or $5.3 million in 2024 alone. These steps were taken to address a projected shortfall of over $10 million in our insurance fund.

For years, Parkway has absorbed rising costs to shield employees from premium increases. Unfortunately, healthcare expenses have now grown so significantly that this is no longer sustainable. Without action, we would not have been able to continue covering medical claims or offering the same level of care to employees and retirees.

The Benefits Advisory Committee Process

Throughout the summer, the Benefits Advisory Committee— made up of Parkway employees from every staff group—met to review options and recommend a path forward. These recommendations are grounded in extensive analysis and input from more than 600 staff and retirees who participated in a districtwide ThoughtExchange. This committee included:

• Teachers
• Operations staff
• Principals
• Nurses
• Retirees
• District administrators
• PNEA President

Timeline

• November 1-30: Open enrollment for 2026 plan year
• January 1, 2026: New plan year begins

Additional Resources:

• Budget webinar with CFO Carrie Nunn
• Board meeting live stream

Parkway is facing a projected shortfall of more than $10 million in its health insurance fund, primarily driven by the rising cost of medical care, services, and prescriptions across the country. In 2024 alone, healthcare expenses rose by 14%, reflecting national and regional trends that are impacting school districts, businesses, and families. 

Without these steps, we will not have sufficient funding to continue offering the same level of healthcare benefits. Making changes now will help ensure that Parkway can continue providing access to high-quality, affordable care in the future.

Parkway is committed to covering most of the shortfall. At the same time, we need to approach this challenge without compromising our ability to support students, pay for essential services, offer competitive salaries, and maintain our buildings.  If Parkway were to absorb the entire shortfall without any adjustments to our premiums or plan coverage, it would have immediate consequences for the district’s overall financial health.

While Parkway has managed rising costs for years—often absorbing increases to avoid raising employee premiums—this year’s surge in healthcare claims was unprecedented. Parkway is contributing an additional $7.5 million to cover a shortage this year. Continuing this approach is no longer sustainable. 

At the same time, our overall revenue growth is limited. Due to new legislation such as the senior citizen tax freeze, Parkway is seeing reduced or stagnant revenue even as our costs, especially for healthcare, continue to rise. 

If Parkway were to absorb the additional shortfall without any adjustments to our premiums or plan coverage, it would have immediate consequences for our overall financial health.  This isn’t just about this year’s budget; it is about the long-term sustainability of our ability to invest in our students, staff, and schools. 

The issue became more urgent in early 2025 and was communicated to staff as part of broader budget updates in March and April. Taking action now helps prevent emergency budget cuts and protects coverage in the long term.

Being self-funded means Parkway doesn’t pay premiums to an insurance company to cover your medical expenses. Instead, the district sets aside money in a special insurance fund to pay all eligible medical claims submitted by employees, retirees, and their dependents.

Here are the benefits of a self-funded model: 

• More control: Parkway can design plans that meet the specific needs of staff and families.
• Lower overhead: We're not paying an insurance company’s profits.
• Flexibility: We can adjust faster to changing healthcare trends.
• More risk: When claims go up significantly, Parkway must cover the difference—not an insurance company.

Last year, claims rose much more than expected, and that trend is continuing in 2025. In a fully insured model, premiums would go up immediately in response. In our self-funded model, we’ve absorbed those increases to shield staff from sudden premium hikes, but there’s a limit to how much more we can do because we have fixed revenue.

The Benefits Advisory Committee, comprising staff from all employee groups, reviewed potential plan changes throughout the summer of 2025. They considered cost data, industry trends, and input from more than 1,600 employees and retirees via a districtwide Thoughtexchange. The committee provided a formal recommendation to the Board of Education, which it approved.

Changes go into effect for the 2026 health insurance plan year.  Employees can choose plan options during Open Enrollment, which takes place from November 1 to 30.

Retirees who subscribe to Parkway’s health plans are impacted as well, since their medical claims are paid from the same self-funded pool. Retirees received direct communication and can also find information on this webpage. Changes, if approved, will also take effect for retirees in January 2026.

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